Characters in "I Know This Much Is True"
- Dominick Birdsey: protagonist.
- Thomas Birdsey: Dominick's identical twin, a paranoid schizophrenic.
- Dr. Patel: Thomas's psychologist at Hatch, Dominick's therapist.
- Lisa Sheffer: Thomas's social worker, Dominick's friend.
- Dessa Constantine: Dominick's ex-wife, whom he remarries.
- Angela Birdsey: Dominick's and Dessa's baby daughter, dies of SIDS.
- Concettina Ipolita Tempesta Birdsey: Thomas's and Dominick's mother, daughter of Domenico and Ignazia Tempesta.
- Ray Birdsey: Thomas's and Dominick's stepfather.
- Leo and Angie (Athena Constantine) Blood: Dominick's best friend, Dessa's younger sister.
- Joy: Dominick's live-in girlfriend.
- Tyffanie Rose: Joy's and Thad's biological daughter, and Dominick and Dessa's adopted daughter.
- Thad: Joy's bisexual half-uncle and secret lover, Tyffanie Rose's father and great half-uncle.
- Ralph Drinkwater: Penny Ann Drinkwater's twin and later found to be Thomas and Dominick's cousin.
- Penny Ann Drinkwater: Ralph Drinkwater's twin, murdered as a small girl.
- Domenico Onofrio Tempesta (1880-1949): Thomas's and Dominick's grandfather from Sicily.
- Ignazia Tucci Tempesta (Violetta d'Annunzio): Dominick's beautiful grandmother from Pescara.
- Prosperine Tucci ("The Monkey"): Ignazia's best friend and lover, loathed by Domenico Tempesta.
- Pasquale Tempesta: Domenico Tempesta's younger brother.
- Vincenzo Tempesta: youngest brother of Domenico Tempesta.
- Concettina Ciccia: Dominick's great-grandmother; Domenico's mother
- Alfio and Maricchia Ciccia: Domenico's maternal grandparents
- Giacomo Tempesta: Domenico's father
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